外科手术腋下纵切口技术的临床应用

APPLICATION OF LONGITUDINAL TRANSAXILLIARY APPROACH AT THORACIC SURGERY

目的 对肺部疾病、纵隔疾病以及胸膜疾病等采用腋下纵切口开胸手术。方法 全麻双腔插管 ,取腋窝中点纵形略向前弯的“ <”形切口 ,长约 1 2～ 1 5cm ,尽量不损伤胸壁各肌群 ,经肋骨上缘入胸腔。结果 与标准后外侧切口对比有切口短、隐蔽在腋窝、创伤轻、出血量少、开、关胸时间短、住院时间短等优点。结论 利用腋下纵切口开胸治疗肺部疾病、纵隔疾病、胸膜疾病是完全可行的。

Objective To approach the application of the longitudinal trans-axilliary approach in the diseases of Lung, Pleural and Mediastinam. Methods Under the anesthesia for general thoracic surgery with double barreled-tube, made a incision about 12-15cm length, proceeded longitudinally from the center point of axilla about 10cm length, then turned to the inferior lateral about 5 cm length that made a shape incision, divided the groups of the muscle, did our best not to cut them, entered the thoracic Cavity from the upper edge of the rib. Results Compared with the posterior lateral incision, the longitudinal transaxilliary approach has some advantages, such as shorter incision which hides in the axilla, milder injured, less bleeding, less time to open and close thoracic caeity and shorted the period of the hospitalization. Conclusion It is practicable to carry out the curative surgery in the diseases of Lung, Pleural and Mediastinum by the longitudinal trans-axilliary approach.